Provider Demographics
NPI:1407378151
Name:GORDON, CATHERINE RICE (NP)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:RICE
Last Name:GORDON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 MASSACHUSETTS AVE NW APT 208
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-2101
Mailing Address - Country:US
Mailing Address - Phone:202-667-4974
Mailing Address - Fax:
Practice Address - Street 1:1711 MASSACHUSETTS AVE NW APT 208
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-2101
Practice Address - Country:US
Practice Address - Phone:202-667-4974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1012548363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health